Ka Wai Ola - Office of Hawaiian Affairs, Volume 37, Number 9, 1 September 2020 — CARING FOR OUR KŪPUNA AN ACT OF ALOHA [ARTICLE+ILLUSTRATION]

CARING FOR OUR KŪPUNA AN ACT OF ALOHA

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By Puanani Fernandez-Akamine "Ua 'ai au i kana loa'a; I have eaten of his gain." Said with pride and affection by a parent who is being cared for by the child they reared Most people hope to grow old in their own homes. No one dreams of someday going to a nursing home to live out their hnal days cared for by strangers. Aging at home is the goal for most of us, especially as the high cost of kūpuna care ean eat through a person's retirement savings, if they have any, in just a few years. But aging at home ean be difficult for kūpuna and their caregivers alike. Diminished abilities, whether physical or mental, ean be extremely distressing for kūpuna, and overwhelming for their caregivers, many of whom are still working and raising their own children while taking care of their elderly parents or grandparents. Here are the stories of three 'ohana who are caring for their kūpuna at home; all women who are caring for their mothers. Despite their individual challenges, the eommon thread running through eaeh mo'olelo is the aloha these women have for their mothers, their sense of kuleana as Hawaiian women, and the joy and peaee they experience in caring for them in the sunset of their lives. To protect their privacy, their names will not be used.

KA 'OHANA (EKAHI Even though "V" had been living on the continent for years, she knew at some point that she might need to move home to O'ahu to care for her parents. But when her father passed away about 15 years ago, her mother was still strong, active and working full-time. When her mother eame to visit eight years ago, however, V noticed that she was starting to slow down. "After that visit I thought to myself that it was almost time to move," V recalled. Next, in what ean only be described as miraculous timing, a job opportunity suddenly became available on O'ahu. V put her house on the market and it sold within a month. "Everything was faster than I thought it would be; it seemed like the timing just worked. Within months of mom's visit we were back home." The 'ohana settled into a niee rhythm, but then four years ago, V's mother had a stroke. Fortunately, she recovered without too many physical challenges, but there was some loss of cognition. V and her 'ohana hoped that the effects of the stroke would be temporary, but it soon became evident she could not return to work. Over time, the 'ohana noticed increasing signs of dementia and V slowly took on additional kuleana for her mom. "At first it was small - managing her medi-

cation and going with her for doctor visits," said V. "But eventually I had to take over her finances, whieh I didn't want to have to do." Two years ago, V realized it was no longer okay for her mother to be home alone during the day. So one of V's sisters who was already retired agreed to stay with their mother while V went to work. Growing up, V had watched her mother take care of her grandmother when she could no longer care for herself and always saw this as her kuleana too. But although she was mentally prepared to someday be a caregiver to her parents, balancing caregiving, a demanding full-time job, and raising her keiki proved exhausting. This situation was exacerbated when V had her own heahh scare a few years ago. Thankfully she is healthy again and has the support of her siblings and her oldest child who provide her with respite when she needs it. This kind of family support is a lesson that V hopes her children are learning. "We didn't have 'ohana on the mainland. Now that we are here, with family around, it helps them to understand that kuleana - how we take care of eaeh other." Reflecting on her role as caregiver to her mother V said, "I think in a Hawaiian family it's just that circle of life. I had an amazing life, a great childhood. My parents did so mueh for me, so at this point I'm just

thankful that I ean give back. At the enel, I want her to be happy and feel like she had great life and was able to do the things she wanted to do. She was the caretaker in our family for everyone else. Sheneverwantedtobeinahome. Mama is now 86 and being at home surrounded by family makes her happy and that's really important. I just hope we ean eonhnue to provide that for her." KA 'OHANA (ELUA When her father had a stroke in 2004, "S's" mother took responsibility for his care. At the time, her father was 7 1 and her mother was 72. Although S and her brother had moved out years before, her parents refused to leave their home of 40 years and downsize. Ten years passed, and her parents' heahh declined. Her father developed cancer and her mother, who had grown increasingly frail, was now exhibiting signs of dementia. At that point, S and her brother, both of whom were working full-time jobs, made the difficult decision to move their father to a private care home because he required skilled nursing. For the next two years, their mother lived alone. S's brother made weekly trips to the house to eheek on her and deliver prepared meals. When their father passed in 2016, the siblings began to explore long-term solutions for their mother, whose cognitive decline continued. They assumed responsibility for their mother's affairs and discovered that their parents had made

some poor hnaneial decisions and the debt on their family home actually exceeded its value. Keeping the house was not an ophon. They prepared to sell, and in 2018 moved their mother in with S. "When mom hrst moved in, she was okay to stay alone during the day," recalled S. "I'd prep her luneh ahead of time and she was fine. But a month after moving in, she fell and broke her hip, and when she was released from the hospital we were told that she needed 24/7 care." Initially, S was able to telework to care for her mother while she healed. She also engaged Bayada Heahh Services who provided a social worker and nurse practioner to kōkua as well. But staying at home indehnitely was not an option. "I have an intense job and a lot of responsibility," shared S, "so when mom was able to get around safely with her walker, I went back to work. And as a precaution, we installed cameras in the house so we could keep an eye on her remotely." "Fortunately, mom is not a wanderer," continued S. "And it's a blessing that she is still independent enough to get around." Between S and her partner, they have worked out a care schedule to minimize the time that her mother is left alone at home. The experience of caring for her mother, now 87, has been a time of personal growth for S. "I've learned a lot about myself - what I'm good at and what I laek. Everytime I have to 'adjust' I have to remind myself that mom is adjusting too. And I've learned to be more patient. I realized that when I found myself looking at my mom as a task that's when I lost

my pahenee." "I never got along with my mom growing up," S confessed. "But my kuleana now is to forgive and be humble and to put my needs on the side so I ean be there for her. It took me a while to eome to this plaee, but this is important for me as a Hawaiian woman; and somehow I am totally benefitting. Caring for mom has been good for me spiritually. I've been able to let go, to forgive and to find peaee. My goal is to keep her here with me for the rest of her life." KA 'OHANA (EKOLU Kupuna neglect and abuse ean happen in any family. That was a shocking realization for sisters "H" and "L" and their brother, "M." "Our sister, 'G,' had been entrusted to care for mom and our family home," said H, "but a few years ago we learned that things were not as they seemed. We uncovered halftruths and complete lies; dealings that were dishonest. It was a broken trust for us." Raised on O'ahu, three of the four siblings had moved to the continent as young adults and made it their home. Only G remained in Hawai'i so after their father passed in 2002, the siblings agreed that G should move into their family home and take care of their mother. SEE ACT 0F AL0HA ON PAGE 19

ACT 0F ALOHA

Continued from page 15 As the years passed, their mother began showing signs of dementia. G assured her siblings that she was taking good care of their mother, but as time went on there were signs that this was not the case. There were concerns about missing funds as well as the level of care their mother was receiving. "We wanted to ho'oponopono but G really had become a different person, very stubborn and obstinate," shared H. H, L and M realized that changes needed to be made and that their mother's care would rest with the three of them moving forward. They began to plan. Then in Febmary 2019, their mother fell, breaking her pelvic bone. She was 90 at the time. The siblings mshed home, fearful that this was it; onee kūpuna fall, many do not recover. Incredibly, she did recover, but that event was the catalyst for them to take decisive action. They moved G and her adult children out of the home. With their husbands' support, H and L created a schedule; the sisters would alternate, eaeh spending 2-3 months at a time in Hawai'i caring for their mother. They agreed to make their brother the trustee of their mother's trust to manage her finances. The family home was in extreme disrepair, so L and her husband took out a loan against their own home to fix it, with agreement from her sister and brother that they would help pay down the loan. Their mother was released from the nursing home in July 2019, so the sisters' care arrangement has now been in plaee for a year. Their trust in one-another

and frequent communication has helped to make an otherwise complicated system successful, although it is not without its challenges. L and her husband moved to the Southwest a few years ago to help their daughter and grandchild. H and her husband run a ministry in the Paeilie Northwest. Both their husbands hold down the fort when they are away, but long periods of separation from their respective spouse is difficult. And caring for a parent suffering from dementia ean feel like a thankless task. "I had a good relationship with my mom growing up," said L. "However, she ean make things hard. She's opinionated and feisty, so H and I have to be stronger and stand firm in a position of authority." The sisters both credit the Lord for getting them through the challenges of the past several years, but there is regret that they did not confront G sooner. "If you suspect abuse of your kupuna's finances or their physical neglect, do something. Don't just trust because it's your sibling," warned L. Having lived so many years on the continent and knowing how friends there have handled the care of their aging parents H said, "I'm so grateful that Ke Akua put me in a culture that values life, keiki to kūpuna. I know there are thousands of Hawaiian families caring for their kūpuna and doing it well, and I'm proud of that." Added L, "Caring for my mom gives me joy and it honors my dad. This isn't what I saw myself doing but it is important. And it models pono behavior; our adult children are watching. Caring for our kūpuna is honorable. This is what Hawaiian people do." ■